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Impact of Excess Skin from Massive Weight Loss on the Practice of Physical Activity in Women

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Abstract

Background

Over 70 % of people who undergo bariatric surgery (BS) develop excess skin (ES). The physical and psychosocial consequences of ES may become a barrier to the practice of physical activity (PA), which is highly recommended to optimize the results of BS. The purpose of this study was to evaluate the impact of ES on the practice of PA in women who have undergone BS.

Methods

Questionnaires administered to 26 women having undergone BS 2 ± 0.2 years before (BMI = 29.1 ± 0.8 kg/m2) evaluated the impacts of ES, the practice of PA, physical self-perception, and physical exercise beliefs. We also used the 6-min walking test and muscular endurance tests to evaluate physical fitness and photographs with anatomical markers to quantify ES.

Results

Of the women, 76.9 % declared mobility limitations due to ES during the practice of PA and 45.2 % stated avoiding PA because of ES which caused flapping and unwelcome stares from others. The women who stated that they avoided PA because of ES had significantly lower physical self-perception and physical fitness and reported experiencing more embarrassment during PA despite no significant difference in the magnitude of ES (p = 0.06), BMI, daily life inconveniences, and energy expenditure compared to those women who did not avoid PA.

Conclusion

Although ES after BS is a barrier to the practice of PA for some women, it does not in itself prevent the regular practice of PA. The main reason women with ES avoid PA seems to have less to do with the magnitude of ES itself and more with psychosocial inconveniences.

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References

  1. Tjepkema M. Nutrition: findings from the Canadian Community Health Survey—adult obesity in Canada: measured height and weight. Statistics Canada Catalogue; 2005.

  2. Sturm R. Increases in morbid obesity in the USA: 2000–2005. Public Health. 2007;121:492–6.

    Article  PubMed  CAS  Google Scholar 

  3. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.

    Article  PubMed  CAS  Google Scholar 

  4. Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.

    Article  PubMed  Google Scholar 

  5. Sjostrom L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–93.

    Article  PubMed  Google Scholar 

  6. van Hout GC, Boekestein P, Fortuin FA, et al. Psychosocial functioning following bariatric surgery. Obes Surg. 2006;16:787–94.

    Article  PubMed  Google Scholar 

  7. Herpertz S, Kielmann R, Wolf AM, et al. Does obesity surgery improve psychosocial functioning? A systematic review. Int J Obes Relat Metab Disord. 2003;27:1300–14.

    Article  PubMed  CAS  Google Scholar 

  8. Biorserud C, Olbers T, Fagevik OM. Patients’ experience of surplus skin after laparoscopic gastric bypass. Obes Surg. 2011;21:273–7.

    Article  PubMed  Google Scholar 

  9. Kitzinger HB, Abayev S, Pittermann A, et al. After massive weight loss: patients’ expectations of body contouring surgery. Obes Surg. 2012;22:544–8.

    Article  PubMed  Google Scholar 

  10. Kinzl JF, Traweger C, Trefalt E, et al. Psychosocial consequences of weight loss following gastric banding for morbid obesity. Obes Surg. 2003;13:105–10.

    Article  PubMed  CAS  Google Scholar 

  11. Mitchell JE, Crosby RD, Ertelt TW, et al. The desire for body contouring surgery after bariatric surgery. Obes Surg. 2008;18:1308–12.

    Article  PubMed  Google Scholar 

  12. Pecori L, Serra Cervetti GG, Marinari GM, et al. Attitudes of morbidly obese patients to weight loss and body image following bariatric surgery and body contouring. Obes Surg. 2007;17:68–73.

    Article  PubMed  Google Scholar 

  13. Coriddi MR, Koltz PF, Chen R, et al. Changes in quality of life and functional status following abdominal contouring in the massive weight loss population. Plast Reconstr Surg. 2011;128:520–6.

    Article  PubMed  CAS  Google Scholar 

  14. Manahan MA, Shermak MA. Massive panniculectomy after massive weight loss. Plast Reconstr Surg. 2006;117:2191–7.

    Article  PubMed  CAS  Google Scholar 

  15. Lazar CC, Clerc I, Deneuve S, et al. Abdominoplasty after major weight loss: improvement of quality of life and psychological status. Obes Surg. 2009;19:1170–5.

    Article  PubMed  Google Scholar 

  16. Jacobi D, Ciangura C, Couet C, et al. Physical activity and weight loss following bariatric surgery. Obes Rev. 2011;12:366–77.

    Article  PubMed  CAS  Google Scholar 

  17. Livhits M, Mercado C, Yermilov I, et al. Exercise following bariatric surgery: systematic review. Obes Surg. 2010;20:657–65.

    Article  PubMed  Google Scholar 

  18. Bond DS, Phelan S, Wolfe LG, et al. Becoming physically active after bariatric surgery is associated with improved weight loss and health-related quality of life. Obesity. 2009;17:78–83.

    Article  PubMed  Google Scholar 

  19. Castello V, Simoes RP, Bassi D, et al. Impact of aerobic exercise training on heart rate variability and functional capacity in obese women after gastric bypass surgery. Obes Surg. 2011;21:1739–49.

    Article  PubMed  Google Scholar 

  20. Stegen S, Derave W, Calders P, et al. Physical fitness in morbidly obese patients: effect of gastric bypass surgery and exercise training. Obes Surg. 2011;21:61–70.

    Article  PubMed  Google Scholar 

  21. Shah M, Snell PG, Rao S, et al. High-volume exercise program in obese bariatric surgery patients: a randomized controlled trial. Obesity. 2011;19:1826–34.

    Article  PubMed  Google Scholar 

  22. Haskell WL, Lee IM, Pate RR, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39:1423–34.

    Article  PubMed  Google Scholar 

  23. Saris WH, Blair SN, van Baak MA, et al. How much physical activity is enough to prevent unhealthy weight gain? Outcome of the IASO 1st Stock Conference and consensus statement. Obes Rev. 2003;4:101–14.

    Article  PubMed  CAS  Google Scholar 

  24. Elkins G, Whitfield P, Marcus J, et al. Noncompliance with behavioral recommendations following bariatric surgery. Obes Surg. 2005;15:546–51.

    Article  PubMed  Google Scholar 

  25. Bond DS, Jakicic JM, Unick JL, et al. Pre- to postoperative physical activity changes in bariatric surgery patients: self report vs. objective measures. Obesity. 2010;18:2395–7.

    Article  PubMed  Google Scholar 

  26. King WC, Hsu JY, Belle SH, et al. Pre- to postoperative changes in physical activity: report from the Longitudinal Assessment of Bariatric Surgery-2. Surg Obes Relat Dis. 2012;8:522–32.

    Article  PubMed  Google Scholar 

  27. Iglesias M, Butron P, Abarca L, et al. An anthropometric classification of body contour deformities after massive weight loss. Ann Plast Surg. 2010;65:129–34.

    Article  PubMed  CAS  Google Scholar 

  28. Beriault K, Carpentier AC, Gagnon C, et al. Reproducibility of the 6-minute walk test in obese adults. Int J Sports Med. 2009;30:725–7.

    Article  PubMed  CAS  Google Scholar 

  29. Larsson UE, Reynisdottir S. The six-minute walk test in outpatients with obesity: reproducibility and known group validity. Physiother Res Int. 2008;13:84–93.

    Article  PubMed  Google Scholar 

  30. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166:111–7.

    Google Scholar 

  31. Gibbons WJ, Fruchter N, Sloan S, et al. Reference values for a multiple repetition 6-minute walk test in healthy adults older than 20 years. J Cardiopulm Rehabil. 2001;21:87–93.

    Article  PubMed  CAS  Google Scholar 

  32. Bohannon RW. Sit-to-stand test for measuring performance of lower extremity muscles. Percept Mot Skills. 1995;80:163–6.

    Article  PubMed  CAS  Google Scholar 

  33. Guralnik JM, Seeman TE, Tinetti ME, et al. Validation and use of performance measures of functioning in a non-disabled older population: MacArthur studies of successful aging. Aging (Milano). 1994;6:410–9.

    PubMed  CAS  Google Scholar 

  34. Dunsky A, Ayalon M, Netz Y. Arm-curl field test for older women: is it a measure of arm strength? J Strength Cond Res. 2011;25:193–7.

    Article  PubMed  Google Scholar 

  35. Craig CL, Marshall AL, Sjostrom M, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35:1381–95.

    Article  PubMed  Google Scholar 

  36. Fox HH, Corbin CB. The physical self-perception profile: development and preliminary validation. J Sports Exerc Psychol. 1989;11:408–30.

    Google Scholar 

  37. Ninot G, Delignières D, Fortes M. L’évaluation de l’estime de soi dans le domaine corporel. Revue STAPS. 2000;53:35–48.

    Google Scholar 

  38. Larsen JK, Geenen R, van Ramshorst B, et al. Binge eating and exercise behavior after surgery for severe obesity: a structural equation model. Int J Eat Disord. 2006;39:369–75.

    Article  PubMed  Google Scholar 

  39. Biddle SJ, Fox KR. Motivation for physical activity and weight management. Int J Obes Relat Metab Disord. 1998;22 Suppl 2:S39–47.

    PubMed  Google Scholar 

  40. World Health Organisation. Process of translation and adaptation of instruments. 2012. http://www.who.int/substance_abuse/research_tools/translation/en/. Accessed 14 May 2012.

  41. Baillot A, Mampuya W, Comeau E, et al. Feasibility and impacts of supervised exercise training in subjects with obesity awaiting bariatric surgery: a pilot study. Obes Surg. 2013. doi:10.1007/s11695-013-0875-5.

  42. Muller-Pinget S, Carrard I, Ybarra J, et al. Dance therapy improves self-body image among obese patients. Patient Educ Couns. 2012;89:525–8.

    Article  PubMed  Google Scholar 

  43. Martin Ginis KA, McEwan D, Josse AR, et al. Body image change in obese and overweight women enrolled in a weight-loss intervention: the importance of perceived versus actual physical changes. Body Image. 2012;9:311–7.

    Article  PubMed  Google Scholar 

  44. Tompkins J, Bosch PR, Chenowith R, et al. Changes in functional walking distance and health-related quality of life after gastric bypass surgery. Phys Ther. 2008;88:928–35.

    Article  PubMed  Google Scholar 

  45. Tessier A, Zavorsky GS, Kim do J, et al. Understanding the determinants of weight-related quality of life among bariatric surgery candidates. J Obes. 2012;2012:713426. doi:10.1155/2012/713426.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The investigators thank Gabrielle Rouleau, a kinesiology B.Sc. student at the Université de Sherbrooke (Canada), for her contribution to data collection and Monique Sullivan for her editorial point of view. Aurelie Baillot is the recipient of a scholarship from the Department of Medicine at Université de Sherbrooke. Marie-France Langlois is the recipient of a National Researcher Scholar Award from the Fonds de recherche du Québec-Santé (FRQ-S). The Étienne-LeBel Clinical Research Center is an FRQ-S-funded research center.

Conflict of Interest Statement

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Étienne-LeBel Clinical Research Center of the Centre Hospitalier Universitaire de Sherbrooke, 3001, 12e avenue Nord, Sherbrooke, QC, Canada, J1H 5N4

    A. Baillot, M. Asselin & M.-F. Langlois

  2. Department of Medicine, Division of Endocrinology, University of Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, QC, Canada, J1H 5N4

    A. Baillot & M.-F. Langlois

  3. Department of Surgery, Division of General Surgery, University of Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, QC, Canada, J1H 5N4

    E. Comeau & A. Méziat-Burdin

Authors
  1. A. Baillot
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  2. M. Asselin
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  3. E. Comeau
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  4. A. Méziat-Burdin
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  5. M.-F. Langlois
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Corresponding author

Correspondence to M.-F. Langlois.

Additional information

Clinical Trials.gov no. NCT01527851

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Baillot, A., Asselin, M., Comeau, E. et al. Impact of Excess Skin from Massive Weight Loss on the Practice of Physical Activity in Women. OBES SURG 23, 1826–1834 (2013). https://doi.org/10.1007/s11695-013-0932-0

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